Nurse practitioner responding to low-level 911 calls in Anaheim to help patients who don't really need a hospital visit

March 15, 2016

Updated March 20, 2016 5:49 p.m.

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Nurse Practitioner Victoria Morrison prepares to leave Fire Station No. 11 in Anaheim on a 911 call that appeared to be lower level and possibilty treatable without a trip to the ER. DREW A. KELLEY, CONTRIBUTING PHOTOGRAPHER

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Nurse Practitioner Victoria Morrison, at Fire Station No. 11 in Anaheim, drives an ambulance to answer some 911 calls that look like they would be treatable without a trip to the emergency room. DREW A. KELLEY, CONTRIBUTING PHOTOGRAPHER

Nurse Practitioner Victoria Morrison, right, and Capt. Paramedic Dave Barry pose for a photograph at Fire Station No. 11 in Anaheim next to the ambulance they use to answer low-level calls that might be treatable without a trip to the emergency room. , DREW A. KELLEY, CONTRIBUTING PHOTOGRAPHER

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Nurse Practitioner Victoria Morrison, right, and Capt. Paramedic Dave Barry pose for a photograph at Fire Station No. 11 in Anaheim next to the ambulance they use to answer low-level calls that might be treatable without a trip to the emergency room. DREW A. KELLEY, CONTRIBUTING PHOTOGRAPHER

Nurse Practitioner Victoria Morrison prepares to leave Fire Station No. 11 in Anaheim on a 911 call that appeared to be lower level and possibilty treatable without a trip to the ER. DREW A. KELLEY, CONTRIBUTING PHOTOGRAPHER

The dispatch call was vague: A 20-year-old woman was sick and needed help.

An oversized rig carrying a team of Anaheim firefighters rolled up to the modest apartment on the city’s west side, followed moments later by an ambulance driven by Victoria Morrison.

Morrison, a nurse practitioner, rushed to the woman’s bedside to take her vital signs and ask a few questions to determine whether she needed to be taken to an emergency room or could be treated at her own home.

Given the symptoms she saw, Morrison advised the woman to go to a hospital.

“A lot of people call 911 because they’re scared,” Morrison said while walking back to the ambulance. “Sometimes they just need a medical professional to treat something small, like a stomachache. Other times they really do need to visit the emergency room.”

Morrison is the sole nurse practitioner working in Anaheim Fire & Rescue’s Community Care Response Unit, which launched May 31 to treat at-home, low-level 911 medical calls, such as nausea or cuts that require stitches. A nurse practitioner can also prescribe medicine.

The one-year pilot program aims to cut costs from the health care system, keep patients from making unnecessary, and potentially costly, trips to the hospital and also freeing up Anaheim firefighters to respond to bigger emergencies in Orange County’s most populous city.

“We’re really good at responding to the traffic accidents, the gunshot wounds and the heart attacks because we have a set protocol for those calls,” said Capt. Dave Barry, the Fire Department’s emergency medical services manager and Morrison’s ride-along partner.

“The tough calls are the low-acuity calls that aren’t really an emergency, where we don’t need to transport someone with the lights and sirens on,” Barry said. “They need another type of care that Victoria has done an excellent job in treating and keeping them out of the hospital.”

Of 230 patients visited by Morrison since the program started, 46 percent were treated on the spot or were advised to visit their primary doctor for further care.

The new program cost about $500,000 this year – that covers the cost of Morrison’s 40-hour weekly salary, medicine, equipment and insurance. The public-private partnership includes Kaiser Permanente, which provided a $210,000 grant, and Care Ambulance Service, which provided a modified ambulance.

Anaheim fire Chief Randy Bruegman said he plans to ask the City Council to continue the program into the next year.

“I think the residents appreciate this alternative model because they get quality care, it costs less money and they get treated right in their own home,” Bruegman said.

Anaheim was the first city in California to adopt the treatment program, modeled after one started in 2008 by Dr. Gary Smith to treat a nasty flu outbreak in Mesa, Ariz. With little funding, the Arizona program lasted three months, but was resurrected in 2011 with help from the city of Mesa and a hospital. It now operates 24 hours a day.

Five cities across the country have followed Smith’s prescription, including Los Angeles.

“We’re striving to be on the leading edge by taking medical service right into the patient’s home, and the results are magnificent,” Smith said.

Patients who opt to be treated by Morrison would still pay the $350 response fee but save the cost of an ambulance ride and ER visit that could run into the thousands of dollars. More importantly, they save time by getting immediate treatment from a health care professional, rather than waiting several hours to see the next available hospital physician.

“Some people think they will be treated faster in the emergency room if they arrive in an ambulance, but that isn’t always the case,” Morrison said.

“My job is to tell them that they’ll get the same level of service from me, and it’s faster.”

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